Demyelinating polyneuropathy is a serious disease that is accompanied by inflammation of the nerve roots with the gradual destruction of the myelin sheath. With proper and timely treatment, the disease can be eliminated, avoiding serious consequences. That is why it is important to know about the main causes and symptoms of the disease in order to consult a doctor in time.
What is a disease? General information
It is immediately worth noting that this disease is quite rare - for 100 thousand people, only 1-2 suffer from a similar ailment. Adult men are more prone to this disease, although women and children may encounter such a diagnosis. As a rule, demyelinating polyneuropathy is accompanied by a symmetric lesion of the nerve roots, resulting in muscle weakness in the distal and proximal limbs. By the way, quite often this disease is associated with Guillain-Barré syndrome. And to this day, it is not known whether chronic inflammatory demyelinating polyneuropathy is a separate disease or one of the forms of the aforementioned syndrome.
The main causes of the development of the disease
Unfortunately, the causes and mechanism of the development of the disease today are not fully known. Nevertheless, long-term studies have shown that inflammatory demyelinating polyneuropathy is an autoimmune disease. For one reason or another, the immune system begins to perceive the cells of its own organism as foreign, resulting in the production of specific antibodies. In this case, these antigens attack the tissues of the nerve roots, causing the destruction of the myelin sheath, causing an inflammatory process. Accordingly, nerve endings lose their basic properties, which leads to disruption of the innervation of muscles and some organs.
In this case, as with almost any other autoimmune disease, genetic heredity occurs. In addition, there are a number of factors that can change the functioning of the immune system. These include metabolic disorders and hormonal disruptions, severe physical and emotional stress, trauma, constant stress, serious illness, infection of the body, vaccination, and surgery.
Demyelinating polyneuropathy: classification
In modern medicine, there are several classification schemes for this disease. For example, depending on the reasons, allergic, traumatic, inflammatory, toxic and some other forms of the disease are distinguished. According to pathomorphology, the demyelinating and axonal varieties of polyneuropathy can be distinguished.
We should also talk about the nature of the course of the disease:
- Acute demyelinating polyneuropathy develops quickly - sensory and motor disorders develop over several days or weeks.
- With a subacute form, the disease does not develop so rapidly, but relatively quickly - from several weeks to six months.
- Chronic polyneuropathy is considered the most dangerous, as it can develop covertly. The progression of the disease can last for several years.
The main symptoms of the disease
The clinical picture with such a disease depends on many factors, including the form of the disease and the reason for its development, the patient’s body characteristics and his age. Demyelinating polyneuropathy, as a rule, at the initial stages is accompanied by the appearance of muscle weakness and some sensory disturbances. For example, patients sometimes complain of decreased sensitivity in the limbs, a burning sensation and tingling sensation. The acute form of the disease is characterized by the appearance of severe girdle pain. But if we are talking about the chronic destruction of nerve roots, then soreness may not be too pronounced or even absent.
As the process progresses, parasthesia of the limbs appears. During the examination, you may notice a decrease or absence of tendon reflexes or their complete disappearance. Most often, the process of demyelination covers precisely the nerve endings of the extremities, but damage to other nerves is not excluded. For example, some patients complain of numbness of the tongue and the area around the mouth. Paresis of the sky is much less common. In this condition, it is difficult for the patient to swallow food or saliva.
Axonal demyelinating polyneuropathy: types and symptoms
Axon destruction is usually caused by toxic effects on the body. The axonal form of the disease is divided into several main types:
- Acute polyneuropathy in most cases develops as a result of serious poisoning of the body (for example, arsenic oxide and other dangerous toxins). Symptoms of a malfunction of the nervous system appear quite quickly - after 14-21 days in the patient, paresis of the lower and upper limbs can be noticed.
- The subacute form of the disease can be caused by both poisoning and serious metabolic failures. The main symptoms can develop over several weeks (sometimes up to 6 months).
- Chronic axonal polyneuropathy develops slowly, sometimes the whole process takes more than five years. As a rule, this form is associated with the presence of a genetic predisposition, as well as prolonged intoxication of the body (observed, for example, in chronic alcoholism).
Diagnostic Methods
Only an experienced doctor can diagnose demyelinating polyneuropathy. Diagnosis of this disease is a complex process, which includes several key points. To begin with, a regular physical examination is carried out and a maximum medical history is collected. If the patient has sensorimotor neuropathy, which develops for at least two months, then this is a good reason for a more accurate diagnosis.
In the future, as a rule, additional studies are conducted. For example, measurements of the speed of conduction of nerve impulses along motor nerves may demonstrate a decrease in the main indicators. And in a laboratory study of cerebrospinal fluid, an increase in protein levels is observed.
What treatment does modern medicine offer?
What therapy does demyelinating polyneuropathy require? The treatment in this case consists of several main stages, namely the removal of the inflammatory process, the suppression of the activity of the immune system and the support of the result.
With exacerbation and the presence of severe inflammation, patients are prescribed hormonal anti-inflammatory drugs, namely corticosteroids. The most effective is Prednisolone and its analogues. Therapy begins with a large dose, which is reduced as the symptoms disappear. As a rule, muscle strength begins to return after a few weeks. But it is worth noting that prolonged use of this medication is fraught with the appearance of serious side effects.
Patients with a chronic form of the disease are often recommended plasmapheresis, which gives good results and even achieve remission. Also, patients are prescribed drugs that can suppress the activity of the immune system - they need to be taken in courses for almost the entire life. One of the new methods of modern therapy is the intravenous administration of immunoglobulin.
Predictions for patients with polyneuropathy
The outcome in this case largely depends on the form of the disease, the quality of the treatment, as well as some individual characteristics of the body. For example, people with an acute form of the disease who quickly received the necessary therapy can tolerate the consequences of the disease much easier. Although complete recovery is far from always achieved, many patients return to their usual way of life.
But chronic demyelinating polyneuropathy, which developed slowly and over the course of several years, can lead to irreversible disturbances in the functioning of the nervous system, disability, and even death. By the way, elderly patients suffer the most severely from this disease.